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cc Following the Pope’s discouraging comments in Cameroon over the use of condoms in relation to the HIV/AIDS pandemic, Nathan Geffen and Rebecca Hodes of Treatment Action Campaign charge that such papal views are misguided and fly in the face of evidence around the efficacy of both condom use and sex education for adolescents.

The Pope’s comments are irresponsible. The evidence that consistent condom use is effective at reducing the risk of HIV transmission is incontrovertible. We’ve reprint the abstract of a scientific meeting that analysed 138 peer-reviewed articles to determine the effectiveness of condoms at reducing the risk of contracting sexually transmitted infections (STIs), including HIV. A key finding of the meeting was that the results of ‘longitudinal studies of the sexual partners of HIV-infected persons indicate that consistent condom use reduces the risk of HIV/AIDS transmission by approximately 85%.’

The evidence is considerable that abstinence-only programmes, apparently favoured by the Pope, are ineffective. The AIDS Research Institute of the University of California, San Francisco, published a monograph in March 2002 that states:

An assessment of the peer-reviewed, published research reveals no evidence that abstinence-only programs delay sexual initiation or reduce STIs or pregnancy. By contrast, credible research clearly demonstrates that some comprehensive sex education, or ‘abstinence-plus’, programs can achieve positive behavioral changes among young people and reduce STIs, and that these programs do not encourage young people to initiate sexual activity earlier or have more sexual partners.

The evidence shows that it is important to distribute condoms and that it is also important to provide sex education to adolescents, including accurate information on how to use condoms.

In Khayelitsha, Cape Town’s largest township, Treatment Action Campaign (TAC) activists distribute over 500,000 condoms every month. A dedicated Khayelitsha activist is nicknamed the ‘Condom King’. A study conducted by Dr Virginia Azevado proved that scaling-up the distribution of condoms to over a million a month in Khayelitsha resulted in a remarkable 50 per cent decline in STI incidence between 2004 and 2007.[1] This is further evidence of the efficacy of condoms as a means of preventing STI infection in poor, African communities.

Preaching abstinence to many communities in Africa is alienating and irrelevant. Many sexual encounters in marginal communities with high rates of HIV infection are coercive or transactional. In contexts in which gender inequality is rife, to instruct women to abstain from sex or to remain faithful to only one partner demonstrates an ignorance of their sexual realities.

The South African Catholic Bishops Conference (SACBC) is a large provider of HIV services in South Africa, including antiretroviral treatment. It is concerning that the views of the leader of the Catholic Church are incongruent with the good work being done by the SACBC.